Chairman Joyce and members of the
Albany County Legislature:

The R Street Institute is a nonprofit,
nonpartisan public policy research organization based out of Washington,
D.C. We strive to promote free markets and effective government policies in
many areas, including tobacco harm reduction.

My academic
background is in the neural mechanisms of addiction, evaluating neurochemical
and anatomical changes that happen in the brain following the onset of
addiction. There has been a lot of progress made toward understanding the biological
factors that lead to dependence and addiction, and we have learned a great deal
about how addiction can best be treated and managed. I believe that harm
reduction approaches can positively affect the health and wellness of people
who use addictive substances, which is why I write to you out of concern about the
proposal to prohibit the sale and distribution of non-tobacco-flavored
e-cigarettes. While well-intentioned, this proposal will adversely affect
public health by limiting safer alternatives to combustible cigarettes for the
very people it aims to protect. We encourage your county to consider policies
that reflect the reduced risk of e-cigarettes compared to combustible

The best available science indicates that e-cigarettes
are not likely to exceed 5 percent of the harm associated with combustible
cigarettes—a conclusion supported by both Public Health England and the
National Academy of Sciences. Also, like traditional nicotine replacement
therapies, e-cigarettes do not produce environmental tobacco smoke that harms
bystanders. Policies that encourage smokers to switch to e-cigarettes if they
cannot or do not wish to quit will significantly reduce the enormous burden of
disease that combustible cigarettes impose on society. It is estimated that
e-cigarettes have the potential to save up to 6 million lives by the year 2100
if only 10 percent of current smokers switch from combustible cigarettes over
the next 10 years. Furthermore, over the last five years, e-cigarettes are
thought to have contributed to a more rapid decline in adolescent smoking rates
than seen in previous years.

The International Journal of Environmental
Research and Public Health
reports that limitations on flavor choices
negatively impact user
. About 40 percent of former and current adult smokers predict
that removing their ability to choose flavors would make them less likely to
remain abstinent or attempt to quit smoking. In fact, data suggests that
current smokers are partial to the flavor of traditional tobacco, while fruit
and sweet flavors are preferred by former smokers.

Policies that
treat e-cigarettes the same as combustible cigarettes encourage current smokers
to continue smoking, to the detriment of their health. Conversely, policies
that reflect the reduced harm of e-cigarettes can significantly decrease the
enormous burden of disease that combustible cigarettes impose on society. This
includes policies that allow flavors to be available to current smokers who
consider them an attractive feature of e-cigarettes.

I applaud the
efforts of Albany County’s legislators to
recognize the impact of smoking and take steps to reduce the prevalence of
smoking and e-cigarette use among youth. Toward that end R Street supports
21-to-purchase initiatives. However, it is important to recognize the potential
of e-cigarettes to mitigate the risks associated with combustible cigarettes if
we wish to encourage a healthful populace.

Thank you for your
time and consideration.

Respectfully submitted,

Dr. Carrie Wade

Director of Harm Reduction Policy

R Street Institute


[email protected]

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